Hello, Cheryl. You wrote about an 18-mo-old who has been ill and is now sucking improperly and tearing up his mother's nipples. You wondered if my method of bottle-feeding would help him re-learn the proper technique. I have to be honest and say I don't know of anyone trying to get such an "older" child to accept a bottle. Most moms would be leary of doing so for fear they would then have trouble weaning from the bottle. And most toddlers who are still breastfeeding are getting sucking needs met at breast, so don't need a bottle. If the mother you are working with decides to give bottle-feeding a try, I would still recommend the small-mouth bottle and a nipple with a base about 1 inch across--*not* the Avent nipple. Although this toddler *might* (and I'll explain why I think he might *not* in a bit) be able to get his mouth around the base of the Avent nipple, this nipple does not have a natural curve (taper) from base to nipple, so it certainly wouldn't teach him how to place his tongue properly against mom's breast. Also, mom's milk sinus has not moved as her baby grew older. If you look at pictures of older babies and toddlers at breast, you will notice that their mouths are *not* as wide as they can possibly be, because that would put their gums behind mom's milk sinus. It might even cause them to gag, since they would be drawing a lot more breast tissue into the mouth and it would naturally be drawing farther back into the mouth, if these babies with larger mouths opened as wide as they could. So, based on mother's anatomy, the small-mouth bottle would still probably be the appropriate bottle to use. And if mom tries this, I would strongly suggest she let the bottle nipple soak in expressed breastmilk for 24 hours before attempting to get toddler to take the bottle, so the nipple tastes a little more like what he's used to. Here's why I'm wondering if this little guy would even be able to get his mouth around that wide Avent nipple base: You talk about how he has pursed lips and tight jaws, even when mom makes him let go and re-attach. You also mentioned that he has had back-to-back colds and has had an earache. (I wasn't clear from your post if the earache came during the time of the colds, or prior to that.) Many times, the thick mucous of colds gets stuck in the eustachian tubes, and babies get ear infections secondarily to the colds. Breastmilk fights infections without inflammation. Breastfed babies can have ear infections without red eardrums, because of the lack of inflammation. But that doesn't mean there isn't extra fluid behind the eardrum. And that extra fluid can cause pain whenever baby tries to open his mouth, because the TMJ (temporomandibular joint) is directly in front of the ear and motion in that joint can cause motion and resulting discomfort in the structures of the ear. Sometimes CranioSacral therapy or pediatric chiropractic can help that excess fluid drain and relieve the pressure. And sometimes, even though not all ear infections need or respond to antibiotics, sometimes I have seen antibiotics help relieve the pain that was keeping a baby from moving his jaw well. I do think that your suggestion to stop using the sippy cups is a good one. This baby seems to be confused about what to do, and handling more than one style of sucking right now may be just more than he can handle. Even if his problem is pain rather than confusion, he might *become* confused as he begins to feel better and he hasn't been able to breastfeed with proper technique in the recent past, because the suck he was most recently able to perform with results was the one he used on his sippy cup. So, for now, mom may indeed need to get that sippy cup out of the picture as baby tries to re-learn the correct attachment and suck as he is able to move his jaw farther. Consistency may be the key to helping him "remember" the right way to breastfeed. Dee Dee Kassing, BS, MLS, IBCLC Collinsville, Illinois, in central USA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html